Little Minos Registration

REgister for little minos

* Indicates required field

Name of Participant *

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Participant date of birth *

Participant Tshirt size *

Parent Name *

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Additional Parent/Guardian Name *

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Email *

Emergency contact Phone Number *

Are there any health concerns/allergies that we need to be aware of? *

As consideration for being permitted by the facilitators to participate in these activities, I hereby release and hold harmless the staff, volunteers, designated coaches, and program officials from all liability, and from all actions or claims that I or my child now or hereafter have for damage, illness or injury to me or my child, or to any person or property, resulting from the negligence or other acts of any employees or volunteers in connection with me or my child’s participation. I further agree that this waiver, release and assumption of risks is to be binding on the heirs and assigns of the undersigned. I further agree to indemnify and to hold the facilitators (its officers, employees, agents and volunteers) free and harmless from any loss, liability, damage, cost or expense which they may incur as a result of any injury, illness and/or property damage that I or my child may cause or sustain while participating in this activity. In case of a medical emergency, I hereby give permission to the Staff, Trainers and Volunteers to order treatment for me or my child, including any necessary medical treatment and x-rays. I also hereby give permission to Staff and Volunteers to disclose the information contained on this form to medical personnel. I understand that an attempt will be made to reach me by phone when a diagnosis is completed.
I HAVE CAREFULLY READ THIS RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT and SIGN IT OF MY OWN FREE WILL.

By typing your name below you agree to the terms and conditions stated above *

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